NAV : Centra Services
ENT/Otolaryngology
ENT Physicians
The InstaTrak® System, developed and manufactured by GE Medical Systems, is an image guided surgery system (IGS) that enables the surgeon to interactively visualize, on a computer monitor, the position of surgical instruments as they move through a patient's sinus anatomy. The System consists of proprietary software, electromagnetic tracking system, and a patented patient headset.
How the InstaTrak System Works:
The InstaTrak System utilizes the patient's preoperative CT scan and electromagnetic tracking technology to provide positional feedback of instrument location within the patient's sinuses. The InstaTrak System's computer compiles the patient's image data from the CT scan and renders three orthogonal views of the sinus anatomy-axial, coronal and sagittal.
The electromagnetic tracking system correlates the movement of surgical instruments to CT images. Two electromagnetic sensors provide positional information on the preoperative CT images displayed on the monitor. One sensor is attached to the instrument and the other is located on the InstaTrak headset. The patient wears the headset during the preoperative CT scan and surgical procedure. The headset enables automatic registration, which is the process of correlating the patient's medical images to the patient's actual anatomy. The electromagnetic sensors attached to the instrument and headset, are registered to show the position of the instrument tip with respect to the CT images of the patient.
The surgical instruments act as pointers that allow the surgeon to visualize, localize and navigate through the patient's sinuses during the procedure. The tip of the instrument is displayed on the InstaTrak System monitor as a set of crosshairs in the axial, coronal and sagittal planes, allowing the surgeon to visualize critical structures such as the cranial bone and orbit.
Preparing for Surgery:
During the preoperative CT scan, the patient wears the headset, which is placed on the bridge of the nose and on the external ear canals. Once the CT scan is obtained, the headset is removed and the images are transferred to the InstaTrak System.
Surgery:
During surgery the System's monitor is positioned for optimal surgeon viewing. Electromagnetic sensors are attached to the headset and the surgical instrument. The headset is again placed on the patient and automated registration occurs, instantly correlating the CT images with the patient's anatomy. The patient's CT images are then displayed on the InstaTrak System's monitor. During the surgical procedure the System plots the precise movement of surgical instruments and correlates them to the patient's medical images.
Sinusitis
What are the sinuses?
The sinuses are made up of four pairs of air filled spaces in the head called the ethmoid, maxillary, sphenoid and frontal sinuses. The sinuses humidify and warm the air that we breathe, and trap and filter particles in the air such as dust, spores and bacteria. Each sinus is lined with tissue or mucous membrane that continuously produces a thin layer of fluid. This fluid keeps the sinuses moist and clean, and drains naturally through the nose.
What is chronic sinusitis?
Sinusitis is the inflammation of the mucous membranes lining the sinuses or air cavities.
What causes sinusitis?
Recurrent colds, allergies or congenital defects can prevent fluid from draining from the sinuses. The resulting blockage can lead to bacterial growth and sinus infection.
What are the symptoms?
Symptoms may include headaches, nasal congestion, post-nasal drip and facial pressure.
Who suffers from chronic sinusitis?
Over 30 million people, or 14% of the U.S. population suffer from chronic sinusitis. *
How is sinusitis treated?
Sinusitis is generally first treated with antibiotics, decongestants and/or
anti-inflammatory drugs. If medication is not effective, or there is a blockage, surgery is generally recommended.
Who performs sinus surgery?
An Ear, Nose and Throat (ENT) specialist or otolaryngologist will recommend the surgical treatment.
Is sinus surgery common?
Over 350,000 sinus surgeries are performed annually in the U.S. *
How is sinus surgery performed?
Since being introduced in 1985, minimally invasive endoscopic sinus surgery (ESS), or functional endoscopic sinus surgery (FESS) is the technique most widely accepted for sinus surgery.
In ESS, an endoscope and small narrow instruments are placed in the nostrils. The endoscope, similar to a miniature telescope, illuminates the surgeon's view of the sinuses. The endoscope allows the surgeon to view the immediate surface area of the sinus cavity. This visualization enables the surgeon to more easily remove diseased tissue and open blocked breathing passages.
What are the drawbacks of ESS?
The endoscope only provides monocular vision. It does not allow the surgeon to see around corners or to locate surgical instruments in the surrounding area. In addition to using the endoscope, the surgeon has to correlate from memory the patient's CT scan with the operative field to determine the location of important anatomical structures that cannot be seen with the endoscope.
Accurate visualization during the surgery is crucial. The paranasal sinuses are located near the brain and eyes; many critical vessels such as the carotid artery and the optic nerve are hidden behind bony structures. Many surgical complications can occur during ESS such as orbital loss of extraocular muscle motion or vision, intracranial cerebrospinal fluid leaking, meningitis or brain abscess. Additionally, blood and tissue can blur the surgeon's vision. These factors can increase the difficulty of the procedure and the possibility of complications.
Is there a less risky surgical option?
GE Medical Systems has developed the InstaTrak System to help the surgeon performing ESS to visualize critical sinus structures. The System utilizes the patient's preoperative CT scan and an electromagnetic tracking device to provide real time three-dimensional image guidance. The System plots precise movement of surgical instruments and correlates them to anatomical structures on the CT scan, which is projected on the InstaTrak System's computer monitor.
*American Academy of Otolaryngology
